Cameroon is known to be endemic for hepatitis B virus infection, but available data on hepatitis delta virus (HDV) prevalence and genetic diversity are limited, inconsistent, and outdated. This study aimed to assess the current HDV prevalence and determine the HDV genotype distribution among patients positive for hepatitis B surface antigen (HBsAg) in Cameroon.
Methods
This cross-sectional study examined patients positive for HBsAg from Cameroon’s 10 administrative regions. Anti-HDV antibodies and HDV viral load (VL) were tested using validated commercial enzyme-linked immunosorbent assay and HDV VL quantification assays. HDV genotypes were determined by the Sanger sequencing method, followed by phylogenetic analysis of the “HDV R0” genome region previously described.
Results
Of the 859 patients positive for HBsAg tested, 142 (16.5%) tested positive for anti-HDV, and HDV RNA was detected in 110 (77.5%) of them. The southern region of Cameroon had the highest infection rate. Notably, an undetectable hepatitis B virus VL was significantly associated with HDV infection (P <0.001). Patients younger than 15 years were the least infected (10%). Five genotypes—HDV-1 (the more prevalent, 83.6%), HDV-5, HDV-6, HDV-7, and HDV-8—were found in the studied population.
Conclusions
Cameroon remains an endemic country for HDV, exhibiting high prevalence, remarkable regional distribution, and wide genetic diversity.
{"title":"Update on the HDV seroprevalence and genotype distribution among patients positive for HBsAg referred to a National Reference Laboratory in Cameroon between January 2019 and December 2020","authors":"Jacques Delors Toumansie Mfonkou , Yacouba Foupouapouognigni , Athenais Gerber , Ségolène Brichler , Frédéric Legal , Abdou Fatawou Modiyinji , Frederic Lissock , Laure Ngono , Boyomo Onana , Emmanuel Gordien , Richard Njouom","doi":"10.1016/j.ijregi.2025.100834","DOIUrl":"10.1016/j.ijregi.2025.100834","url":null,"abstract":"<div><h3>Objectives</h3><div>Cameroon is known to be endemic for hepatitis B virus infection, but available data on hepatitis delta virus (HDV) prevalence and genetic diversity are limited, inconsistent, and outdated. This study aimed to assess the current HDV prevalence and determine the HDV genotype distribution among patients positive for hepatitis B surface antigen (HBsAg) in Cameroon.</div></div><div><h3>Methods</h3><div>This cross-sectional study examined patients positive for HBsAg from Cameroon’s 10 administrative regions. Anti-HDV antibodies and HDV viral load (VL) were tested using validated commercial enzyme-linked immunosorbent assay and HDV VL quantification assays. HDV genotypes were determined by the Sanger sequencing method, followed by phylogenetic analysis of the “HDV R0” genome region previously described.</div></div><div><h3>Results</h3><div>Of the 859 patients positive for HBsAg tested, 142 (16.5%) tested positive for anti-HDV, and HDV RNA was detected in 110 (77.5%) of them. The southern region of Cameroon had the highest infection rate. Notably, an undetectable hepatitis B virus VL was significantly associated with HDV infection (<em>P</em> <0.001). Patients younger than 15 years were the least infected (10%). Five genotypes—HDV-1 (the more prevalent, 83.6%), HDV-5, HDV-6, HDV-7, and HDV-8—were found in the studied population.</div></div><div><h3>Conclusions</h3><div>Cameroon remains an endemic country for HDV, exhibiting high prevalence, remarkable regional distribution, and wide genetic diversity.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100834"},"PeriodicalIF":1.7,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To report a case of chorioretinitis without papilledema caused by Bartonella henselae in an immunocompetent patient.
Observations
A 27-year-old female patient with a history of multiple cat scratches presented on August 28, 2025, with a gradual decline in visual acuity in her right eye. This decline had been developing for 3 weeks following scratches from cats and was accompanied by a fever of 39°C. Optical coherence tomography revealed serous retinal detachment with associated epithelial detachment. Fluorescein angiography showed a hyperfluorescent perimacular focus in the superior temporal region, consistent with chorioretinitis characterized by star-shaped macular exudates, and there was no evidence of papilledema. HIV-1 and 2 serology was negative. Serum protein electrophoresis returned normal results, and the HbA1c level was 5.5%. Serology for B. henselae was positive (immunoglobulin [Ig]G and IgM) with titers greater than 1:1280 and 1:1200. The treatment plan included doxycycline (100 mg every 12 hours) for 6 weeks and rifampicin (300 mg every 12 hours) with corticosteroid therapy (1 mg/kg) for 4 weeks. Fluorescein angiography conducted 6 weeks after treatment showed a hypofluorescent area in the superior temporal region of the macula, indicating that the star-shaped macular exudates had disappeared. The patient reported improved visual acuity, although they experienced slight blurred vision in the right eye.
Conclusions
Ocular bartonellosis can lead to unusual eye damage, specifically chorioretinitis, even in the absence of papilledema.
{"title":"Atypical ocular bartonellosis: A case report","authors":"Kamena Mwana-Yile HASSAN , Fatima IHBIBANE , Mathilde OTSASSO , Latifa MARIH","doi":"10.1016/j.ijregi.2025.100830","DOIUrl":"10.1016/j.ijregi.2025.100830","url":null,"abstract":"<div><h3>Objectives</h3><div>To report a case of chorioretinitis without papilledema caused by <em>Bartonella henselae</em> in an immunocompetent patient.</div></div><div><h3>Observations</h3><div>A 27-year-old female patient with a history of multiple cat scratches presented on August 28, 2025, with a gradual decline in visual acuity in her right eye. This decline had been developing for 3 weeks following scratches from cats and was accompanied by a fever of 39°C. Optical coherence tomography revealed serous retinal detachment with associated epithelial detachment. Fluorescein angiography showed a hyperfluorescent perimacular focus in the superior temporal region, consistent with chorioretinitis characterized by star-shaped macular exudates, and there was no evidence of papilledema. HIV-1 and 2 serology was negative. Serum protein electrophoresis returned normal results, and the HbA1c level was 5.5%. Serology for <em>B. henselae</em> was positive (immunoglobulin [Ig]G and IgM) with titers greater than 1:1280 and 1:1200. The treatment plan included doxycycline (100 mg every 12 hours) for 6 weeks and rifampicin (300 mg every 12 hours) with corticosteroid therapy (1 mg/kg) for 4 weeks. Fluorescein angiography conducted 6 weeks after treatment showed a hypofluorescent area in the superior temporal region of the macula, indicating that the star-shaped macular exudates had disappeared. The patient reported improved visual acuity, although they experienced slight blurred vision in the right eye.</div></div><div><h3>Conclusions</h3><div>Ocular bartonellosis can lead to unusual eye damage, specifically chorioretinitis, even in the absence of papilledema.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100830"},"PeriodicalIF":1.7,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-19DOI: 10.1016/j.ijregi.2025.100827
Meiji Soe Aung , Hajime Onomi , Atsushi Taniguchi , Koji Kuronuma , Satoshi Takahashi , Nobumichi Kobayashi
As the increase in infections due to community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), monitoring of colonization in healthy population is becoming more significant. From nasal cavity of two preclinical medical students who were originally healthy and had neither foreign travel history nor contact with animals, methicillin-resistant S. aureus (MRSA) strains were isolated. For these MRSA, the genotypes, prevalence of virulence factors and antimicrobial resistance determinants were analyzed, along with antimicrobial susceptibility test. These strains were genotyped as (i) ST8-SCCmec-IVl, which was “CA-MRSA/J” clone, known as a unique Panton-Valentine leukocidin (PVL)-negative ST8 MRSA in Japan, and (ii) ST1930-SCCmec-IVa, which belonged to CC96, one of the livestock-associated MRSA, while being a rare type in humans (first detection in Japan). Both strains were susceptible to most antimicrobials, except for oxacillin, and continued to colonize the students for 1 year. These MRSA strains were successfully decolonized by the treatment with nasal ointment of mupirocin, and the eradication of ST8 MRSA strain was confirmed for at least 1 year. The present study revealed the persistent colonization of the rare CA-MRSA clones in healthy adults with unknown route of transmission, suggesting the importance to screen CA-MRSA and its decolonization in healthy individuals.
{"title":"Persistent nasal colonization of rare community-acquired methicillin-resistant Staphylococcus aureus clones ST8-IVl (CA-MRSA/J) and ST1930-IVa in healthy adults","authors":"Meiji Soe Aung , Hajime Onomi , Atsushi Taniguchi , Koji Kuronuma , Satoshi Takahashi , Nobumichi Kobayashi","doi":"10.1016/j.ijregi.2025.100827","DOIUrl":"10.1016/j.ijregi.2025.100827","url":null,"abstract":"<div><div>As the increase in infections due to community-acquired methicillin-resistant <em>Staphylococcus aureus</em> (CA-MRSA), monitoring of colonization in healthy population is becoming more significant. From nasal cavity of two preclinical medical students who were originally healthy and had neither foreign travel history nor contact with animals, methicillin-resistant <em>S. aureus</em> (MRSA) strains were isolated. For these MRSA, the genotypes, prevalence of virulence factors and antimicrobial resistance determinants were analyzed, along with antimicrobial susceptibility test. These strains were genotyped as (i) ST8-SCC<em>mec</em>-IVl, which was “CA-MRSA/J” clone, known as a unique Panton-Valentine leukocidin (PVL)-negative ST8 MRSA in Japan, and (ii) ST1930-SCC<em>mec</em>-IVa, which belonged to CC96, one of the livestock-associated MRSA, while being a rare type in humans (first detection in Japan). Both strains were susceptible to most antimicrobials, except for oxacillin, and continued to colonize the students for 1 year. These MRSA strains were successfully decolonized by the treatment with nasal ointment of mupirocin, and the eradication of ST8 MRSA strain was confirmed for at least 1 year. The present study revealed the persistent colonization of the rare CA-MRSA clones in healthy adults with unknown route of transmission, suggesting the importance to screen CA-MRSA and its decolonization in healthy individuals.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100827"},"PeriodicalIF":1.7,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-19DOI: 10.1016/j.ijregi.2025.100826
Yoshio Nakano, Hiroka Serizawa, Iwao Gohma
Capnocytophaga canimorsus sepsis is potentially fatal, even in immunocompetent hosts. This report describes a case involving a 57-year-old woman, who developed fever after a dog bite and initially presented without an evident focus. On the day of admission, she deteriorated to pulseless electrical activity during transport and achieved return of spontaneous circulation after approximately 23 minutes of resuscitation. Broad-spectrum antimicrobials (meropenem) were initiated for septic shock, and Capnocytophaga canimorsus subsequently grew in both the pre-admission and admission blood cultures. Peripheral discoloration suggested purpura fulminans. A precipitous decline in platelet count, schistocytosis, elevated lactate dehydrogenase levels, and acute kidney injury fulfilled the criteria for thrombotic microangiopathy, whereas ADAMTS13 activity was normal. Intensive care consisted of red blood cell and platelet transfusions, continuous hemodiafiltration transitioning to intermittent hemodialysis, mechanical ventilation with tracheostomy, and therapeutic plasma exchange once daily for three sessions. Hematological abnormalities resolved, schistocytes disappeared, organ dysfunction improved, and she was ultimately removed from ventilation and dialysis with full neurological recovery. This report describes survival after cardiopulmonary arrest due to Capnocytophaga canimorsus sepsis and suggests that plasma exchange may be a useful adjunct for secondary thrombotic microangiopathy in this setting. Early diagnosis, prompt antibiotic treatment, and multidisciplinary critical care are essential.
{"title":"Survival after cardiopulmonary arrest due to Capnocytophaga canimorsus sepsis: A case successfully managed using plasma exchange","authors":"Yoshio Nakano, Hiroka Serizawa, Iwao Gohma","doi":"10.1016/j.ijregi.2025.100826","DOIUrl":"10.1016/j.ijregi.2025.100826","url":null,"abstract":"<div><div>Capnocytophaga canimorsus sepsis is potentially fatal, even in immunocompetent hosts. This report describes a case involving a 57-year-old woman, who developed fever after a dog bite and initially presented without an evident focus. On the day of admission, she deteriorated to pulseless electrical activity during transport and achieved return of spontaneous circulation after approximately 23 minutes of resuscitation. Broad-spectrum antimicrobials (meropenem) were initiated for septic shock, and Capnocytophaga canimorsus subsequently grew in both the pre-admission and admission blood cultures. Peripheral discoloration suggested purpura fulminans. A precipitous decline in platelet count, schistocytosis, elevated lactate dehydrogenase levels, and acute kidney injury fulfilled the criteria for thrombotic microangiopathy, whereas ADAMTS13 activity was normal. Intensive care consisted of red blood cell and platelet transfusions, continuous hemodiafiltration transitioning to intermittent hemodialysis, mechanical ventilation with tracheostomy, and therapeutic plasma exchange once daily for three sessions. Hematological abnormalities resolved, schistocytes disappeared, organ dysfunction improved, and she was ultimately removed from ventilation and dialysis with full neurological recovery. This report describes survival after cardiopulmonary arrest due to Capnocytophaga canimorsus sepsis and suggests that plasma exchange may be a useful adjunct for secondary thrombotic microangiopathy in this setting. Early diagnosis, prompt antibiotic treatment, and multidisciplinary critical care are essential.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100826"},"PeriodicalIF":1.7,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The increasing burden of extensively drug-resistant tuberculosis (XDR-TB) undermines global TB control efforts.
Methods
This was a case series study conducted from January 1, 2007, to December 31, 2024, in the Department of Pulmonology at Sylvanus Olympio University Teaching Hospital.
Results
We report a series of three cases. Case 1: A 30-year-old man with a history of contact with an XDR-TB case was treated with a 20-month regimen. Culture conversion was achieved at the 3rd month of treatment. A complication in the form of pyopneumothorax occurred during the 6th month of therapy. Case 2: A 51-year-old patient with no significant medical history was diagnosed with XDR-TB after 4 months of treatment for multidrug-resistant TB (MDR-TB). Conversion of follow-up cultures was achieved 2 months after modification of the treatment regimen. Case 3: A 62-year-old woman living with human immunodeficiency virus (HIV), previously treated for MDR-TB, developed XDR-TB during the course of treatment. The patient died on the 29th day of XDR-TB treatment.
Conclusions
XDR-TB is a curable disease. Early and accurate diagnosis allows for better selection of the most appropriate treatment strategy.
{"title":"Extensively drug-resistant tuberculosis in Togo: first reported cases and implications for tuberculosis control","authors":"Maïssala Zoutené , Akouvi Mawussé Edjodjinam Ako , Koffi Atsu Aziagbe , Narcisse Viani Gateu Tadjom , Tété Amento Stéphane Adambounou , Komi Séraphin Adjoh","doi":"10.1016/j.ijregi.2025.100825","DOIUrl":"10.1016/j.ijregi.2025.100825","url":null,"abstract":"<div><h3>Objectives</h3><div>The increasing burden of extensively drug-resistant tuberculosis (XDR-TB) undermines global TB control efforts.</div></div><div><h3>Methods</h3><div>This was a case series study conducted from January 1, 2007, to December 31, 2024, in the Department of Pulmonology at Sylvanus Olympio University Teaching Hospital.</div></div><div><h3>Results</h3><div>We report a series of three cases. Case 1: A 30-year-old man with a history of contact with an XDR-TB case was treated with a 20-month regimen. Culture conversion was achieved at the 3<sup>rd</sup> month of treatment. A complication in the form of pyopneumothorax occurred during the 6<sup>th</sup> month of therapy. Case 2: A 51-year-old patient with no significant medical history was diagnosed with XDR-TB after 4 months of treatment for multidrug-resistant TB (MDR-TB). Conversion of follow-up cultures was achieved 2 months after modification of the treatment regimen. Case 3: A 62-year-old woman living with human immunodeficiency virus (HIV), previously treated for MDR-TB, developed XDR-TB during the course of treatment. The patient died on the 29th day of XDR-TB treatment.</div></div><div><h3>Conclusions</h3><div>XDR-TB is a curable disease. Early and accurate diagnosis allows for better selection of the most appropriate treatment strategy.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100825"},"PeriodicalIF":1.7,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-09DOI: 10.1016/j.ijregi.2025.100823
Alisa Khan , Tariq Jagnarine
Objectives
Despite the introduction of pre-exposure prophylaxis (PrEP) in Guyana as an effective HIV prevention tool, its uptake remains low among key and vulnerable populations, such as men who have sex with men, sex workers, and transgender individuals. This study assessed awareness, uptake, and barriers to PrEP among seronegative individuals in Guyana and proposed strategies to improve accessibility and use.
Methods
A cross-sectional, mixed-method study was conducted among 90 seronegative adults across Regions 3, 4, 6, and 10. Quantitative data were collected via structured questionnaires, whereas qualitative insights were gathered through interviews and focus group discussions. Statistical analyses (chi-square) and thematic coding were applied.
Results
Among participants, 59% were aware of PrEP, primarily through media sources (43%), whereas only 18% had ever been offered PrEP by a health care provider. None of the participants were active users. The key barriers identified were limited access (48%), fear of side effects (27%), and inadequate provider engagement. However, 57% expressed willingness to use PrEP and 74% would recommend it to peers.
Conclusions
PrEP awareness in Guyana is moderate but constrained by systemic barriers, misinformation, and health care inaccessibility. Strengthening provider training, integrating PrEP into routine services, and community outreach are essential to improve uptake.
{"title":"Pre-exposure prophylaxis in Guyana: linking key populations and other vulnerable groups","authors":"Alisa Khan , Tariq Jagnarine","doi":"10.1016/j.ijregi.2025.100823","DOIUrl":"10.1016/j.ijregi.2025.100823","url":null,"abstract":"<div><h3>Objectives</h3><div>Despite the introduction of pre-exposure prophylaxis (PrEP) in Guyana as an effective HIV prevention tool, its uptake remains low among key and vulnerable populations, such as men who have sex with men, sex workers, and transgender individuals. This study assessed awareness, uptake, and barriers to PrEP among seronegative individuals in Guyana and proposed strategies to improve accessibility and use.</div></div><div><h3>Methods</h3><div>A cross-sectional, mixed-method study was conducted among 90 seronegative adults across Regions 3, 4, 6, and 10. Quantitative data were collected via structured questionnaires, whereas qualitative insights were gathered through interviews and focus group discussions. Statistical analyses (chi-square) and thematic coding were applied.</div></div><div><h3>Results</h3><div>Among participants, 59% were aware of PrEP, primarily through media sources (43%), whereas only 18% had ever been offered PrEP by a health care provider. None of the participants were active users. The key barriers identified were limited access (48%), fear of side effects (27%), and inadequate provider engagement. However, 57% expressed willingness to use PrEP and 74% would recommend it to peers.</div></div><div><h3>Conclusions</h3><div>PrEP awareness in Guyana is moderate but constrained by systemic barriers, misinformation, and health care inaccessibility. Strengthening provider training, integrating PrEP into routine services, and community outreach are essential to improve uptake.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100823"},"PeriodicalIF":1.7,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: Enzyme-linked immunosorbent assay (ELISA)–based QuantiFERON-TB Gold Plus (QFT-Plus ELISA) testing is associated with manual variability and indeterminate results. The transition from QFT-Plus ELISA to chemiluminescent immunoassay (CLIA) for QuantiFERON-TB Gold Plus (QFT-Plus CLIA) testing represents a significant methodological evolution that requires comprehensive evaluation. This systematic review and meta-analysis aimed to assess method agreement, characterize systematic bias patterns, evaluate clinical concordance between DiaSorin's QFT-Plus CLIA and QIAGEN's (QFT-Plus ELISA) methodologies, and determine sources of heterogeneity across diverse populations for latent tuberculosis infection (LTBI) detection.
Methods: We searched the PubMed, Embase, and Google Scholar databases from January 2019 to January 2025 for studies comparing QFT-Plus CLIA and QFT-Plus ELISA methodologies for LTBI detection. Two reviewers independently screened the studies and assessed their quality using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. We conducted a meta-analysis of agreement measures using random-effects models, systematic bias characterization, meta-regression analysis of the sources of heterogeneity, and clinical subgroup analysis. Evidence certainty was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). The review was registered with PROSPERO (CRD420251031884).
Results: A total of 16 studies comprising 4169 participants were included. A meta-analysis of 10 studies (n = 2932) revealed a substantial overall concordance of 88.76% (95% confidence interval [CI] 83.57-93.95). Among the seven studies with complete data to calculate positive and negative agreement measures (n = 1305), the pooled positive agreement was 91.3% (95% CI 88.95-93.65) and the negative agreement was 93.89% (95% CI 92.18-95.6). The comparative analysis revealed a mean discordance rate of 6.56% (range: 0.44-16.67%), with a weighted mean directional bias of +0.2% (showing minimal overall directional preference between platforms). Significant heterogeneity was observed (I² = 95.8%, P <0.0001), and evidence certainty was rated “very low” due to methodological limitations.
Conclusions: Diasorin's QFT-Plus CLIA and QIAGEN's QFT-Plus ELISA demonstrated substantial overall agreement in detecting LTBI, with the strongest concordance for clearly positive and negative results. Laboratories implementing QFT-Plus CLIA platforms should consider verification studies, and future research should evaluate the clinical significance of discordant results and optimize interpretive algorithms for diverse epidemiologic settings.
目的:基于酶联免疫吸附试验(ELISA)的QuantiFERON-TB Gold Plus (QFT-Plus ELISA)检测与人工变异和不确定结果相关。QuantiFERON-TB Gold Plus (QFT-Plus CLIA)检测从QFT-Plus ELISA到化学发光免疫分析法(CLIA)的转变代表了一种重要的方法学进化,需要进行全面的评估。本系统综述和荟萃分析旨在评估方法的一致性,表征系统偏倚模式,评估DiaSorin的QFT-Plus CLIA和QIAGEN的QFT-Plus ELISA方法之间的临床一致性,并确定不同人群中潜伏性结核感染(LTBI)检测的异质性来源。方法:我们检索了2019年1月至2025年1月的PubMed、Embase和谷歌Scholar数据库,以比较QFT-Plus CLIA和QFT-Plus ELISA方法检测LTBI的研究。两名审稿人独立筛选研究并使用诊断准确性研究质量评估2 (QUADAS-2)工具评估其质量。我们使用随机效应模型、系统偏倚表征、异质性来源的元回归分析和临床亚组分析对一致性测量进行了荟萃分析。证据确定性采用推荐、评估、发展和评价分级(GRADE)进行评估。该综述已在PROSPERO注册(CRD420251031884)。结果:共纳入16项研究,4169名受试者。10项研究(n = 2932)的荟萃分析显示,总体一致性为88.76%(95%可信区间[CI] 83.57-93.95)。在有完整资料计算阳性和阴性一致性测度的7项研究(n = 1305)中,阳性一致性为91.3% (95% CI 88.95-93.65),阴性一致性为93.89% (95% CI 92.18-95.6)。对比分析显示,平均不一致率为6.56%(范围:0.44-16.67%),加权平均方向偏差为+0.2%(平台之间的总体方向偏好最小)。观察到显著的异质性(I²= 95.8%,P <0.0001),由于方法学的限制,证据确定性被评为“非常低”。结论:Diasorin的QFT-Plus CLIA和QIAGEN的QFT-Plus ELISA在检测LTBI方面显示出大量的总体一致性,在明确的阳性和阴性结果方面具有最强的一致性。实施QFT-Plus CLIA平台的实验室应考虑验证研究,未来的研究应评估不一致结果的临床意义,并优化不同流行病学背景下的解释算法。
{"title":"Agreement and systematic bias between QuantiFERON chemiluminescent immunoassay and QuantiFERON enzyme-linked immunosorbent assay in the detection of latent tuberculosis infection: A systematic review and meta-analysis","authors":"Felix Bongomin , Ivaan Pitua , Phillip Ssekamatte , Diana Sitenda , Irene Andia-Biraro , Bwambale Jonani","doi":"10.1016/j.ijregi.2025.100824","DOIUrl":"10.1016/j.ijregi.2025.100824","url":null,"abstract":"<div><div>Objectives: Enzyme-linked immunosorbent assay (ELISA)–based QuantiFERON-TB Gold Plus (QFT-Plus ELISA) testing is associated with manual variability and indeterminate results. The transition from QFT-Plus ELISA to chemiluminescent immunoassay (CLIA) for QuantiFERON-TB Gold Plus (QFT-Plus CLIA) testing represents a significant methodological evolution that requires comprehensive evaluation. This systematic review and meta-analysis aimed to assess method agreement, characterize systematic bias patterns, evaluate clinical concordance between DiaSorin's QFT-Plus CLIA and QIAGEN's (QFT-Plus ELISA) methodologies, and determine sources of heterogeneity across diverse populations for latent tuberculosis infection (LTBI) detection.</div><div>Methods: We searched the PubMed, Embase, and Google Scholar databases from January 2019 to January 2025 for studies comparing QFT-Plus CLIA and QFT-Plus ELISA methodologies for LTBI detection. Two reviewers independently screened the studies and assessed their quality using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. We conducted a meta-analysis of agreement measures using random-effects models, systematic bias characterization, meta-regression analysis of the sources of heterogeneity, and clinical subgroup analysis. Evidence certainty was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). The review was registered with PROSPERO (CRD420251031884).</div><div>Results: A total of 16 studies comprising 4169 participants were included. A meta-analysis of 10 studies (n = 2932) revealed a substantial overall concordance of 88.76% (95% confidence interval [CI] 83.57-93.95). Among the seven studies with complete data to calculate positive and negative agreement measures (n = 1305), the pooled positive agreement was 91.3% (95% CI 88.95-93.65) and the negative agreement was 93.89% (95% CI 92.18-95.6). The comparative analysis revealed a mean discordance rate of 6.56% (range: 0.44-16.67%), with a weighted mean directional bias of +0.2% (showing minimal overall directional preference between platforms). Significant heterogeneity was observed (I² = 95.8%, <em>P</em> <0.0001), and evidence certainty was rated “very low” due to methodological limitations.</div><div>Conclusions: Diasorin's QFT-Plus CLIA and QIAGEN's QFT-Plus ELISA demonstrated substantial overall agreement in detecting LTBI, with the strongest concordance for clearly positive and negative results. Laboratories implementing QFT-Plus CLIA platforms should consider verification studies, and future research should evaluate the clinical significance of discordant results and optimize interpretive algorithms for diverse epidemiologic settings.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100824"},"PeriodicalIF":1.7,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-03DOI: 10.1016/j.ijregi.2025.100822
Meghavi Kathpalia , Loick P. Kojom Foko , Pragya Rawat , Rini Chaturvedi , Manju Rahi , Amit Sharma
India has significantly reduced its Plasmodium vivax (P. vivax, Pv) malaria burden. However, threat of chloroquine (CQ) resistance can undermine these gains. Artemisinin-based combination therapies (ACTs) have demonstrated superior efficacy compared to CQ, particularly in regions where resistance Pv has been confirmed. Their benefits include rapid parasite clearance, improved tolerability, effectiveness against mixed-species infections, and reduced relapse rates when combined with primaquine (PQ). While the World Health Organization recommends changing the first-line treatment if the total failure rate exceeds 10%, some countries have acted earlier based on surveillance of putative drug resistance molecular markers. In India, therapeutic efficacy studies (TES) coverage can be expanded is sparse along with molecular data to track early warning tools of Pv resistance. This review synthesizes clinical, molecular, and pharmacological evidence supporting a shift from CQ to ACTs for P. vivax. We argue that India may prioritize TES expansion and adopt an ACT-based regimen to sustain its elimination momentum and prevent therapeutic failure.
{"title":"Plasmodium vivax elimination from India may need therapeutic efficacy studies - Informed shift to artemisinin-based treatment","authors":"Meghavi Kathpalia , Loick P. Kojom Foko , Pragya Rawat , Rini Chaturvedi , Manju Rahi , Amit Sharma","doi":"10.1016/j.ijregi.2025.100822","DOIUrl":"10.1016/j.ijregi.2025.100822","url":null,"abstract":"<div><div>India has significantly reduced its <em>Plasmodium vivax</em> (<em>P. vivax, Pv</em>) malaria burden. However, threat of chloroquine (CQ) resistance can undermine these gains. Artemisinin-based combination therapies (ACTs) have demonstrated superior efficacy compared to CQ, particularly in regions where resistance <em>Pv</em> has been confirmed. Their benefits include rapid parasite clearance, improved tolerability, effectiveness against mixed-species infections, and reduced relapse rates when combined with primaquine (PQ). While the World Health Organization recommends changing the first-line treatment if the total failure rate exceeds 10%, some countries have acted earlier based on surveillance of putative drug resistance molecular markers. In India, therapeutic efficacy studies (TES) coverage can be expanded is sparse along with molecular data to track early warning tools of <em>Pv</em> resistance. This review synthesizes clinical, molecular, and pharmacological evidence supporting a shift from CQ to ACTs for <em>P. vivax</em>. We argue that India may prioritize TES expansion and adopt an ACT-based regimen to sustain its elimination momentum and prevent therapeutic failure.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"18 ","pages":"Article 100822"},"PeriodicalIF":1.7,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.ijregi.2025.100806
Kassim Abdi Jimale, Shafie Abdulkadir Hassan, Abdifetah Ibrahim Omar
{"title":"The urgent need for Middle East respiratory syndrome coronavirus surveillance in Somalia","authors":"Kassim Abdi Jimale, Shafie Abdulkadir Hassan, Abdifetah Ibrahim Omar","doi":"10.1016/j.ijregi.2025.100806","DOIUrl":"10.1016/j.ijregi.2025.100806","url":null,"abstract":"","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"17 ","pages":"Article 100806"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We aimed to determine the prevalence of dengue among febrile patients in Bamako and explore its seasonal and demographic variations.
Methods
We conducted cross-sectional surveys in July 2021 and February 2022 among febrile patients seeking care at four community health centers in Bamako. Febrile patients were enrolled, and blood samples were tested for dengue using rapid diagnostic tests and polymerase chain reaction.
Results
A total of 325 patients were enrolled (175 in July and 150 in February). The overall prevalence of dengue in communes V and VI of Bamako was 16.9%. Females were more represented (66.2%). The median age of the participants was 20 years (interquartile range: 8-30). Adult age (≥18 years) was the only factor significantly associated with an increased risk of dengue infection (odds ratio = 3.2; 95% confidence interval: 1.1-9.4).
Conclusions
The prevalence of dengue (16.9%) in communes V and VI suggests that dengue is endemic in Bamako, with a predominance among young adults and females. Adult age was identified as the only significant factor associated with increased risk. Further studies are needed for more insight into the dynamics of dengue transmission and to guide public health actions, particularly those targeting the adult population, to reduce dengue transmission in Bamako.
{"title":"Prevalence of dengue virus among febrile patients in urban setting of Bamako, Mali","authors":"Yacouba Cissoko , Mountaga Diallo , Hermine Meli , Emmanuel Mberkadji Dingamwal , Ibrehima Guindo , Fousseyni Kané , Dramane Ouedraogo , Bakary Monzon Diarra , Ibrahim Cisse , Daouda Thiero , Bréhima Togola , Demba Koita , Oumar Magassouba , Dramane Sogoba , Mariam Soumaré , Assetou Fofana , Issa Konate , Seydou Doumbia , Sounkalo Dao","doi":"10.1016/j.ijregi.2025.100788","DOIUrl":"10.1016/j.ijregi.2025.100788","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to determine the prevalence of dengue among febrile patients in Bamako and explore its seasonal and demographic variations.</div></div><div><h3>Methods</h3><div>We conducted cross-sectional surveys in July 2021 and February 2022 among febrile patients seeking care at four community health centers in Bamako. Febrile patients were enrolled, and blood samples were tested for dengue using rapid diagnostic tests and polymerase chain reaction.</div></div><div><h3>Results</h3><div>A total of 325 patients were enrolled (175 in July and 150 in February). The overall prevalence of dengue in communes V and VI of Bamako was 16.9%. Females were more represented (66.2%). The median age of the participants was 20 years (interquartile range: 8-30). Adult age (≥18 years) was the only factor significantly associated with an increased risk of dengue infection (odds ratio = 3.2; 95% confidence interval: 1.1-9.4).</div></div><div><h3>Conclusions</h3><div>The prevalence of dengue (16.9%) in communes V and VI suggests that dengue is endemic in Bamako, with a predominance among young adults and females. Adult age was identified as the only significant factor associated with increased risk. Further studies are needed for more insight into the dynamics of dengue transmission and to guide public health actions, particularly those targeting the adult population, to reduce dengue transmission in Bamako.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"17 ","pages":"Article 100788"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}